This morning started with an extra large drain on my battery. Clarence needed even more of my time than usual. Once again he asked, “When am I going to start feeling better?” Clarence has late-stage prostate cancer and is now in his 80s. For 12 years, nearly everything we have used to fight his disease has worked—each time adding time to his life. But the signs of decline are now clear: more lost weight each visit, increasing pain in the bones, and food tasting like cardboard. He has a clipping from the newspaper offering the latest “cure” for cancer. Unfortunately, it tells of a new success in pediatric leukemia! Clarence’s health food advisor has suggested he try a mixture of cleansing salts that you simply add to water, and is “sure to cure.” I have also noticed that Clarence’s relatives are not making as many visits to his room. Trying not to show the exasperation on my face, I reply, “Clarence, maybe it is time to let God take the reins. I’m running out of tricks in my bag.” But he insisted, “No chance doc, I’m going to beat this thing.” To Clarence, there remains no question who is in control of his life, and no question of who will win this war of mind-over-matter. And it is not God.
WHEN I LEFT MY TRAINING IN oncology, I thought my job was to practice medicine. No one took the time to tell me just how many hats I would be asked to wear: physician, counselor, comforter, confidant, pastor and friend. It also did not take very long to realize what I was good at, and not so good at. There was one Sunday morning when one of my own church members lay in bed on the cancer ward and cautiously asked me, “Dr. Fintel, you know I’ve served our church for 35 years. I know that we both love the Lord, but what I don’t know is why He let this happen to me.” Without missing a beat, I reached down to my belt, felt for the pager switch, made it beep, and hightailed it for the nursing station, not to return that morning. It was not one of my finer moments. Now, years later, I realize that I cannot go to the next patient’s room without the fullness of the Holy Spirit. Without the patience of the Spirit, I could not deal with Clarence. But I did not always realize this. Years of medical training taught me to depend not on God, but on science and reason. About 15 years ago that began to change. Dr. Gerald McDermott was teaching Sunday school at my church and I was struck by the clarity of his thinking and instruction. Gerry is a theologian at Roanoke College and has written widely on Christian faith, and especially the American theologian, Jonathan Edwards. After class, we began a relationship that has produced, not only a friendship and a book,1 but also a change in my practice of oncology. I had been a doctor who was a Christian, and I then began the rocky transition to a Christian who is a doctor.
THATSUNDAYMORNINGYEARS ago, I didn’t walk to the nurses’ station, I ran. None of my textbooks or journals could help me answer the “why” question of cancer. Today, I know there are many good biblical and theological answers, but the hard part is getting to the right ones, while avoiding two temptations. The first temptation occurs when someone tries to provide an answer that doesn’t belong. The second, for the Christian, is to look for answers that cannot be supported biblically. Let me try to illustrate. Not long ago on hospital rounds, I encountered a patient in tears. That is not such an unusual sight on the cancer ward, but for Aleisha it was not typical. She is one courageous woman. At 35, she has battled back from a nearly life-ending car wreck, dealt with the issues of being a single mom, and was now in the hospital recovering from double mastectomies for what we hope is curable breast cancer. So what brought the tears? Ironically, it was a good friend. This friend had committed what I consider a cardinal mistake. The “friend” told Aleisha that God was trying to tell her to get to church more often, and was using breast cancer as a punishment. A face slap, so to speak, not only to gain attention, but to chastise and redirect. What’s more, she added, “I go to church every Sunday.” I wanted to cry, too, but for different reasons. The first, and perhaps biggest, mistake comes by not realizing that only the sufferer can know for sure the best explanation for her suffering, if she finds one at all. It may come only from the passage of time. It may take a re-reading of the Bible. A wise and experienced counselor may have the privilege of saying the right thing at the right time, if asked. If the greatest good from suffering can be the spiritual peace the cancer patient experiences in finally finding an answer that works, then one of the greatest harms is having the answer imposed at the wrong moment, the wrong place, and usually from the wrong person. That is what Job’s friends did. They thought they knew why suffering had come to Job, and were eager to share their opinions. God, however, rebuked them. The second mistake comes from not seeing the big picture. Simple answers make that mistake. One thing that God and His creation are not, is simple. Cancer patients and their families, even those with a deep faith, often remain confused about why God has permitted their trauma. For Aleisha’s friend to assume a cause-and-effect relationship between her breast cancer and her church attendance denies the totality of the biblical message. God doesn’t usually work that way. The Bible depicts several instances in which those people who assume that suffering is a punishment for sin are directly rebuked. There is the case of the man born blind, whose story is told in the Gospel of John. Jesus’ disciples asked if the blindness was a result of the man’s sin or his parent’s sin. Jesus replied categorically that neither had been responsible: “He is blind so that God’s power might be seen at work in him” (John 9:3 TEV). Christine is a devout patient of mine whose cancer returned after an eight-year hiatus. Her answer to the why question is astounding to me. Like any Christian parent, she yearned for her son to be saved. He had fought off a relationship with Jesus with all his might, despite the steady witness of parent and friends. Now, as Chris faced cancer yet again, the son began to seek God. Remarkably, Chris’ chemotherapy demolished her next tumor. And through the whole battle, Chris exhibited a peace that passed all human understanding. Shortly after gaining remission, she was overjoyed to see him in church, rededicating his life to Christ, with the clear reasoning that whatever his mother had inside her heart, he also wanted! Christine told me, with tears streaming down her face, “My cancer was the means God used to bring my son back to Himself. I can die now, and be happy.” I couldn’t hold back my own tears. Why does God allow cancer? There are so many reasons, including some beyond our comprehension. C.S. Lewis gave one answer in The Problem of Pain: pain, he said, is “God’s megaphone to a deaf world.” Cancer shatters the illusion that all is well. It can turn us from ourselves, to others, to Him, to a higher calling. Perhaps we all don’t see it as some sort of weird cosmic “gift” to get cancer, but many have seen it that way. For some of my patients, the question is not, “Why me?” but “Why not me?” Kelly, a 65-year-old man with final stage lung cancer told me, “God has given me a good life. I realize that cancer is part of a fallen world. And that this is God’s way of bringing me home.” The “why” question is not the only tough question—“Can God heal me?” is another one. But, here, too, answers can be too simple. Clara came to me five years ago with a neglected breast cancer. She had been using prayer alone while the lump in her breast grew larger. After firing two oncologists who would not work with her plan, she asked me for help. The cancer had now spread to many organs, and seemingly didn’t frighten her. She still accepts only a minimum of modern treatment and thoroughly frustrates several specialists by refusing most medical care. To Clara, her tumor is a test of her faith in God, her church family and the power of prayer. Every office visit is a prayer session. With each office visit, she searches my face for good news and I rarely have any. She relies on select passages in scripture that imply we can all be healed and protected in every circumstance. Clara, like Clarence, is clearly in her last days. The pain I feel as I care for her is really no different from what I feel with Clarence. It is the pain of watching another human being pour their trust, like water, into a bucket with holes. Not that I do not believe in supernatural healing! I do, and will explain. But God never promises that He will physically heal every sickness.2 S The apostle Paul wrote in Romans 8 that all of creation groans under the curse of suffering and won’t be released from the curse till the end of the world. Believers, too, he wrote, await the “redemption of our bodies”(Romans 8:22-23). If the Bible really teaches that God intends all believers to be free of disease, why does it say that suffering will remain until the end? That is not to say that God is out of the healing business today. He clearly does heal, in the lives of my patients and throughout history. What I haven’t been able to figure out is His rhyme and reason —why He heals some and not others. There was a time in my career when I had blinders on God’s working to “stir the soup.” That is what I tell patients it is like to have God working in my medical practice. My wife, Connie, will be the first to tell you that I don’t spend much time cooking soup, but I like to think of God as the Great Cook, watching me try to season the meal, continually directing the cooking. Occasionally, I sense His direction. One of the first times I sensed His guidance was when I was working on our first cancer book with Gerry. I had told him I did not believe in supernatural healing because I had never seen it. Then that Christmas, I sent pastor Jim home to die. Taking care of Jim had been like caring for my father, my pastor and my favorite teacher all rolled into one. He had retired from the ministry after 40 years, and suffered with leukemia the last four years of his life. When I sent him home that last time his blood was rotten. There were no good white cells, only bad—very little hemoglobin and terribly thin on clotting factors. To add to the misery, the morning after discharge, the lab called me to say that cultures from his bloodstream were growing a species of staphylococcus. But, none of that really mattered much as his family gathered to celebrate his life and support each other while he died. Two weeks later, when Jim came to see me, he looked better than I expected. We drew some blood tests and found a partial correction of his cells. In another two weeks his blood tests had normalized! Over the next 18 months, he and I enjoyed many more visits. We actually filmed our “story” for the youth group at our church. Jim and his wife, Margaret, were able to celebrate two more anniversaries before the leukemia finally returned and took Jim away from us. As a physician, I knew I had seen a “spontaneous remission.” (That is what we doctors like to call it.) As a Christian, I had witnessed a miracle, privileged to see God take over after medicine had failed.
SEEINGGOD AT WORKSOMETIMES takes real practice. Miraculous healings are fairly easy to spot. But God’s hand is sometimes hard to see. One of my jobs is to care for the dying through the work of Good Samaritan Hospice in Roanoke, Virginia. Hospice is a multidisciplinary team that provides nursing care, family support and medication to people who have chosen to quit fighting their terminal illness. When Dana came to me, she was a young mother gradually succumbing to metastatic breast cancer. One of Dana’s goals before her death was to see Matthew, her five-year-old son, get on the school bus and begin kindergarten. By the grace of God, and true grit, she achieved this goal. In September of that year, Matthew’s teacher began a Christmas fund for each child. Matthew was to bring one nickel each week, and in December, they would buy a present for one of their parents, wrap it, and place it under the classroom tree. As Dana’s cancer progressed, it became clear that she would not make it to Christmas day. At the same time, she knew that the gift her son had purchased was a tiny imitation diamond ring. Knowing her time was short; she asked him if she could open her present early. Matthew was clear on this, “Mom, you always tell me not to open my presents early. So you shouldn’t either.” Dana knew she couldn’t open it without confusing her little boy, so she promised him she would wait. Unfortunately, her cancer did not wait. The Lord took her home, but from her own bed and surrounded by her family. At the funeral, those of us who knew about the ring were overwhelmed when we saw on Dana’s ring finger—in place of her wedding ring—a tiny imitation diamond ring. Little Matthew had put it on his mother’s finger. We heard later that Dana had instructed her husband to give Matthew her wedding ring as a memory of her love for him, and to tell their little boy that she would be proud to wear his ring to heaven.
GOD IS ALWAYSWITH US. He takes the journey with Dana and Matthew. He heals pastor Jim for a few extra years. He gives me the courage to face Clarence every week, and the words to share with Aleisha as she lies there wounded. Seeing God at work in the lives of the people around me is no longer difficult. He answers some prayers with a resounding “Yes” and others with a mysterious “No.” When the answer is “No” my job can be really hard. The transition from hope for healing, either through medicine or God, to hope for heaven, is a hard process. If I have learned anything in these last 16 years, it is to simply hang in there. Patients can feel abandoned by their doctors. If I were to tell Clarence to take a hike and find another doctor so that I wouldn’t have to put up with his refusal to face reality, I would not be representing Jesus. If I were to tell Clara I cannot see her any more because all she really wants is a faith healer, I would not be showing the love and patience of the Holy Spirit. One morning, Clarence will (most likely) look up at me from the bed and simply say, “It’s over, isn’t it, doc?” And Clara may come to realize that God does not always choose to heal. I know I do the most damage when I emotionally C or spiritually “check out” on these difficult patients. That is precisely why I ‘hang in there,’ and especially why I need to depend on the Holy Spirit. It is why I am so thankful for the patients who have told me that they pray for me, my family and even my marriage. As Chris tells me, “I ask God to put a hedge of comfort around you and your family.” We all have known sufferers who bear their burdens with such grace that we feel lightened in their presence. To be with them as friend, family or physician is an honor. I have learned from them to:
• Live one day at a time. Savor small pleasures, like the gift of waking up.
• Ask God for help to make it through this day.
• Put people and relationships ahead of things and ambitions.
• Visit a friend and reminisce, laugh, and sometimes cry together.
• Visit an avoided ‘enemy.’ Try to pull down old walls and heal old wounds.
• Make a gift for an unborn grandchild; describe your passions, your dreams and concerns for your family.
• Make Jesus Christ a more prominent part of my day. Find quiet time each day for prayer and scripture. Cancer is a disease that we would not wish on anyone. But it is only a disease, and is becoming less of a foe every year. Cancer may come and go, or come and stay. It is not a death sentence to the majority of those who face it. Countless thousands have used the experience of cancer as an opportunity to grow. For those who find a richer life with God and with those you love through your pain, whether you survive cancer or not, I believe you surely have conquered it. ENDNOTES 1 William Fintel & Gerald McDermott, (2004), Cancer: A Medical and Spiritual Guidebook for Patients and Their Families. 2 God refused to heal Paul’s thorn in the flesh (2 Corinthians 12:1-10), and David’s son (2 Samuel 12:15-18). He tells us we all have a “time to die” (Ecclesiastics 3:2). And through it all, it seems that his message is that there are some things— such as his everlasting presence in life and death—that are more important than this earthly life that we tend to value above all other things.
William A. Fintel, M.D., is a practicing oncologist in southwest Virginia. After growing up in the Midwest, he and his wife, Connie, have made their home and raised four sons in the Blue Ridge Mountains. Hospice care for the terminally ill is another of his passions; a last great opportunity for sharing love, healing wounds and ministry.
